Rhode Island - Statewide Postpartum Hypertension Remote Surveillance

Conditions studied

Hypertension in Pregnancy, Postpartum Preeclampsia, Postpartum Complication

About this study

This is a hybrid type 1 non-inferiority implementation effectiveness trial among postpartum patients with hypertension (N=1536) that will test the hypothesis that RI-SPHERES (a technologically enabled collaborative care model) is non-inferior to a standard self-measured blood pressure program in terms of persistent hypertension at six weeks postpartum and preventive care receipt within one year of delivery.

Interventions

• Behavioral: RI-SPHERES — Participants assigned to the RI-SPHERES group will be introduced virtually or in-person to the care manager (CM), who demonstrate how to communicate directly with patients through the app for medical or non-medical needs. Each participant will learn how to obtain SMBP, sync the LTE-enabled BP cuff to the RI-SPHERES app, and respond to adaptive messaging pertaining to BP measurements, which include the ability to receive on-demand education on postpartum topics (e.g., HDP, breastfeeding, mood disorders) per participant preference. During the study period, the CM will respond to needs elicited from the SDoH screening by facilitating referrals to community resources. After six weeks, the focus of RI-SPHERES will transition to preventive care in addition to SMBP. The CM will engage monthly with each study participant to ensure they have a primary care provider and to facilitate preventive care visits or specialist appointments, if needed.
• Behavioral: Standard self-measured blood pressure program — Participants assigned to the routine care group meet virtually or in-person with a member of WIH's existing SMBP program and enroll in WIH's EPIC MyChart Portal to allow the SMBP program to receive patient-entered BP measurements and respond to messages. Participants will be provided with BP cuffs and taught how to obtain SMBP and report their BP through MyChart. At six weeks postpartum, WIH SMBP staff send a MyChart message to recommend BP ascertainment once per month and to describe the importance of attending a clinical visit with a primary care provider within a year of birth.

Primary outcomes

• Persistent hypertension (Six weeks postpartum)

Eligibility information

Study locations

• Newport Hospital, Newport, Rhode Island 02840 United States
• Women & Infants Hospital of Rhode Island, Providence, Rhode Island 02903 United States
• South County Hospital, Wakefield, Rhode Island 02879 United States
• Kent Hospital, Warwick, Rhode Island 02886 United States
• Landmark Hospital, Woonsocket, Rhode Island 02895 United States